![]() ![]() Compliance to adjuvant treatment hasīeen a major concern in our daily practice and this may haveĪffected the survival outcome. Survival (OS) and disease-free survival (DFS) ( 3). Have not shown an improvement in distant recurrence, overall Rectal cancer as it has shown a decrease in local recurrence fromģ0-50% to ~5% and allowed the patients to have sphincter preservingĬhemotherapy is advisable, but it is still controversial as studies TME has made a revolution in the management of Outcome for stage II and III rectal cancer ( 1). Multimodality treatment including radiation, chemotherapy and total (LARC) from single modality treatment using surgery alone to Longer follow‑up is required.įor the past 3 decades, we have been witnessingĭynamic changes in the treatment of locally advanced rectal cancer No difference was noted in the 2‑year DFS. A numerically higher pCR rate, and nodal and tumor downstaging were noted in the TNT group without significance. In conclusion, the present study revealed that patients treated with TNT were more compliant to chemotherapy than those treated with CRT. All 26 patients in the TNT group received neoadjuvant chemotherapy, where 22 (84.6%) patients took a full course (P<0.001). Out of 55 patients in the CRT group, 30 patients received adjuvant chemotherapy, 22 (40.0% of CRT cases) of which completed a full course. The 2‑year disease‑free survival (DFS) rate was 81.0% in the TNT group and 84.0% in the CRT group (P=0.15). A total of 19 (35.8%) cases in the CRT group downstaged to pT0N0 or pT1N0 compared with 11 (42.3%) in the TNT group (P=0.33). In the CRT group, 15 (27.3%) patients achieved pathologic complete response (pCR) compared with 10 (38.5%) in the TNT group (P=0.22). A total of 81 patients were included, among which 55 (67.9%) received CRT and 26 (32.1%) received TNT. The total neoadjuvant therapy (TNT) group received 6 cycles mFOLFOX and a short course of radiation therapy followed by surgery. The chemoradiation therapy (CRT) group received a long course of CRT with capecitabine followed by surgery and adjuvant chemotherapy. In this retrospective study, the charts of patients diagnosed with cT3/4 or cT2‑node‑positive rectal cancer between January 2011 and June 2019 were reviewed. This multimodality treatment improves local control but is associated with low compliance rates without clear beneficial effects on overall survival (OS) and distant metastasis. The current standard of care for locally advanced rectal cancer (LARC) includes preoperative chemoradiation, followed by total mesorectal excision and adjuvant chemotherapy. ![]()
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